腹腔镜手术治疗急性肠梗阻的有效性及安全性分析

Analysis of effectiveness and safety of laparoscopic surgery for patients with acute intestinal obstruction

目的探究急性肠梗阻患者选用腹腔镜手术治疗的有效性和安全性。方法98例急性肠梗阻患者,采取数字编号随机抽取方式分为对照组和观察组,各49例。对照组选用常规手术治疗,观察组选用腹腔镜手术治疗。对比两组手术前后的血清前白蛋白(PA)、C反应蛋白(CRP)、降钙素原(PCT)水平及生存质量评分,部分临床指标(手术时间、术中出血量、首次通气时间、住院时间、复发率),临床疗效,并发症发生率。结果术后,两组的PA水平高于本组术前,CRP、PCT水平低于本组术前,且观察组的PA(234.45±13.21)mg/L高于对照组的(209.67±14.46)mg/L,CRP(3.15±0.89)mg/L、PCT(0.25±0.09)μg/L低于对照组的(6.69±1.21)mg/L、(0.36±0.07)μg/L,差异具有统计学意义(P<0.05)。术后,两组的生理功能、心理功能、社交功能、环境状态、独立状态、自我情绪评分均高于本组术前,且观察组的生理功能、心理功能、社交功能、环境状态、独立状态、自我情绪评分分别为(78.32±5.75)、(80.67±5.53)、(78.78±5.59)、(75.59±3.48)、(77.74±5.33)、(82.11±3.78)分,高于对照组的(67.46±5.87)、(72.43±5.46)、(69.61±5.31)、(67.47±3.55)、(68.83±5.44)、(70.87±4.42)分,差异具有统计学意义(P<0.05)。观察组的手术时间(59.56±4.31)min、首次通气时间(40.21±8.57)h、住院时间(3.75±0.78)d短于对照组的(76.57±5.15)min、(52.32±9.16)h、(5.42±0.89)d,术中出血量(106.35±10.31)ml少于对照组的(123.56±11.48)ml,复发率4.08%低于对照组的16.33%,差异具有统计学意义(P<0.05)。观察组总有效率95.92%高于对照组的83.67%,差异具有统计学意义(P<0.05)。观察组并发症发生率2.04%低于对照组的12.24%,差异具有统计学意义(P<0.05)。结论腹腔镜手术治疗急性肠梗阻效果显著,能够有效缩短治疗时间,降低手术治疗风险,术后并发症发生率低,有助于患者身体早日康复,提高生活质量,值得临床积极借鉴。

Objective To investigate the effectiveness and safety of laparoscopic surgery for patients with acute intestinal obstruction.Methods A total of 98 patients with acute intestinal obstruction were randomly divided into the control group and the observation group by numerical numbering,with 49 cases in each group.The control group was treated with conventional surgery,while the observation group was treated with laparoscopic surgery.Both groups were compared in terms of serum prealbumin(PA),C-reactive protein(CRP),procalcitonin(PCT)and quality of life score before and after surgery,and some clinical indicators(operation time,intraoperative blood loss,first ventilation time,hospital stay,recurrence rate),clinical efficacy,and complication rate.Results After surgery,the PA in the two groups were higher than that before surgery in this group,and the CRP and PCT were lower than those before surgery in this group;the PA(234.45±13.21)mg/L in the observation group was higher than(209.67±14.46)mg/L in the control group;the CRP(3.15±0.89)mg/L and PCT(0.25±0.09)μg/L in the observation group were lower than(6.69±1.21)mg/L and(0.36±0.07)μg/L in the control group;the differences were all statistically significant(P<0.05).After surgery,the scores of physiological function,psychological function,social function,environmental state,independent state and self-emotion in the two groups were higher than those before operation in this group;the scores of physiological function,psychological function,social function,environmental state,independent state and self-emotion in the observation group were(78.32±5.75),(80.67±5.53),(78.78±5.59),(75.59±3.48),(77.74±5.33)and(82.11±3.78)points,which were higher than(67.46±5.87),(72.43±5.46),(69.61±5.31),(67.47±3.55),(68.83±5.44)and(70.87±4.42)points in the control group;the differences were all statistically significant(P<0.05).The operation time(59.56±4.31)min,first ventilation time(40.21±8.57)h,and hospital stay(3.75±0.78)d of the observation group were shorter than(76.57±5.15)min,(52.32±9.16)h,and(5.42±0.89)d of the control group;the intraoperative blood loss(106.35±10.31)ml of the observation group was less than(123.56±11.48)ml of the control group;the recurrence rate 4.08%of the observation group was lower than 16.33%of the control group;the differences were all statistically significant(P<0.05).The total effective rate 95.92%of the observation group was higher than 83.67%of the control group,and the difference was statistically significant(P<0.05).The incidence of complications 2.04%in the observation group was lower than 12.24%in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic surgery is effective in the treatment of acute intestinal obstruction,and can effectively shorten the treatment time,reduce the risk of surgical treatment,and reduce the incidence of postoperative complications,which can help patients recover early and improve their quality of life,and is worthy of active clinical reference.